4 Inhaled Agents

Question 1

Fluorine atom #: sevo, iso, des. Which has a chlorine

Answer 1

7, 5, 6. Iso

Question 2

How to calc partial pressure of a gas

Answer 2

Vol % x total gas pressure (760)

Question 3

Gases that make comp A vs CO

Answer 3

Sevo= comp A. CO= des > iso

Question 4

Effect of FRC, time constant, dead space, and pa-pv diff on FA/FI

Answer 4

FRC, time constant, and dead space dec wash in/dec FA/FI. Pa-PV if low increases FA/FI

Question 5

Body mass %: VRG, muscle/skin, fat, vessel poor

Answer 5

10, 50, 20, 20

Question 6

CO %: VRG, muscle/skin, fat, vessel poor

Answer 6

75, 20, 5, <1

Question 7

Order of tissues with anesthetic uptake first to last

Answer 7

Vessel rich, muscle, fat, vessel poor

Question 8

Hepatic biotransformation % hi to low

Answer 8

Sevo 2%, iso 0.2%, des 0.02, nitrous 0.004

Question 9

High output renal failure: agent responsible, why, signs

Answer 9

Sevo, fluoride ions. Polyuria, hypernatremoa, hyperosmolarity, inc creatinine

Question 10

Concentrating effect

Answer 10

Volume inc the amount of rise fa/FI

Question 11

How right to left shunt affects speed of induction, which agents most effected

Answer 11

Slows speed of induction. Low solubility (des) effected the most

Question 12

Right to left shunts 5

Answer 12

Tet of fallot, foramen o vale, eisenmengers dis, tricuspid atresia, Epstein’s anomaly

Question 13

Effect on iv induction: right to left shunt, left to right shunt

Answer 13

Right to left speeds induction. Left to right slows induction

Question 14

How long to avoid n20: sf6, air, perfluoropropane, silicone

Answer 14

10 days, 5 days, 30 days, not applicable

Question 15

Mac awake, ma char

Answer 15

0.4 on induction/0.15 on emergence. 1.5

Question 16

Drugs that inc mac

Answer 16

Chronic etoh, amphetamines, cocaine, Maois, ephedrine, levodopa

Question 17

Drugs that dec mac

Answer 17

Acute etoh, iv anes, n20, opioids, lithium, A2 agonists, lido, hydroxyzine

Question 18

Lytes that inc/dec mac

Answer 18

Low Na dec mac, hi inc mac

Question 19

How age inc or dec mac

Answer 19

1-6 months inc mac. Older age (6% per decade after 40) and prematurity dec mac

Question 20

Inhib pathways stim by VAs

Answer 20

GABA, glycine, k ch

Question 21

Stim pathways that VA inhibit

Answer 21

Na ch, nmda, nicotinic, dendritic spine

Question 22

Sites va bind to in SC

Answer 22

Glycine, nmda, na

Question 23

Where nitrous and xenon effect body

Answer 23

Nmda antag and k channel stim (not gaba)

Question 24

IA fx on hr

Answer 24

Des, iso, n2o inc. sevo no change. Xenon dec

Question 25

IA fx BP

Answer 25

Des/iso/sevo dec (iso dec most), n20 same or inc, xenon same

Question 26

IA fx CO and SVR

Answer 26

Xenon no change. Iso dec both. Des and sevo same or dec CO, both dec SVR. N20 dec co inc SVR

Question 27

Greatest to least Coronary artery dilation

Answer 27

Iso, des, sevo

Question 28

Apneic threshold usually is what

Answer 28

3-5 mmhg below paco2 maintained at SV

Question 29

CO2 response curve right v left shift meaning

Answer 29

Right shift, min vent less than predic, resp acid. Left shift min vent more than predicted, resp alk

Question 30

Carotid body more sensitive to what v aortic body

Answer 30

Carotid= 02, co2, h. Aortic= BP

Question 31

VA impair which chemoreceptors several hrs after anes

Answer 31

Peripheral

Question 32

Inhib of hypoxic drive most to least

Answer 32

Sevo, iso, des

Question 33

Mac required to create isoelectric state

Answer 33

1.5-2

Question 34

Gas fx CSF production

Answer 34

No change: iso. Same or inc: des. Dec: sevo

Question 35

Gas fx csf absorp

Answer 35

Iso inc, des and sevo no change

Question 36

When amplitude dec by ____ or latency inc by ____ should be concerned about ischemia

Answer 36

50%, 10%

Question 37

Anes fx: BAEP, VEP

Answer 37

BAEP effected the least. VEP effected the most

Question 38

If pt has a hx of halothane hepatitis which agent best and why

Answer 38

Sevo: metab to fluoride but not tfa